Kornimate/medical-research-clean huggingface dataset:
adaptive decision support for addiction treatment master

Conditions: Opioid Use Disorder

Summary: this study refines and optimizes the embed\* clinical decision support (cds; see nct03658642) to increase number of ed physicians following standard of care for the administration of buprenorphine to appropriate patients with opioid use disorder. this study does not have open enrollment. investigators will use a multiphase optimization strategy (most) framework study with preparation, optimization, and confirmatory phases. optimization phase: this phase has two stages. in stage 1, investigators will conduct a 2x2x2 factorial trial to expand embed is expanded to include sustainable implementation strategies: nurse prompt for withdrawal assessment, and targeted clinician prompts to use the cds along with individualized patient resources to promote equity and motivate readiness to start treatment. in stage 2, investigators will improve cds usability via serial randomized testing to inform iterative refinement of the cds interface and workflow to minimize user errors, task disruption, and abandonment through identification of specific targets for improvement via application of novel cds outcome measures in serial randomized tests. evaluation phase: investigators will conduct a randomized trial to compare the efficacy effectiveness of the optimized package compared to the original on ed-initiation of buprenorphine rates in patients with oud. \*embed is a user user-centered, clinician clinician-facing clinical decision support system integrated into the electronic health record workflow to facilitate initiating buprenorphine in the emergency department by: diagnosing opioid use disorder with a checklist based on the diagnostic criteria of the dsm-5 (diagnostic and statistical manual of mental disorders, fifth edition), assessing the severity of withdrawal with the clinical opioid withdrawal scale (cows), motivating patients to accept treatment with a scripted brief negotiation interview, and automating the electronic health record workflow, including clinical and after visit documentation, order entry, prescribing, and referral for ongoing treatment in the community


Eligibility criteria:
inclusion criteria: * emergency department patient * 18 years of age or older * moderate to severe opioid use disorder exclusion criteria: * under 18 years of age * pregnant * currently receiving medication for opioid use disorder

Keywords: opioid use disorder clinical decision support
the iuss crohn's study: a feasibility study

Conditions: Crohn Disease; Inflammatory Bowel Diseases

Summary: the aim of this study is to evaluate if an intraoperative protocol for ultrasound scan (uss) is feasible and safe in patients undergoing elective surgery for ileocolic cd. the results of this study could guide the development of a larger randomised trial.

to date the intraoperative clinical assessment of location and extent of ileocolic cd has been left at the discretion of the operating surgeon guided by a mixture of experience, tactile feedback, macroscopic appearance and results of preoperative imaging, with significant intra and inter surgeon variability, potentially resulting in long segments of small bowel being removed unnecessarily, which is a significant concern in patients at risk of several abdominal surgeries and of developing "short bowel syndrome". at surgery, the operating surgeon also evaluates the full length of the small bowel to locate and assess further areas of cd: a process called "disease mapping". this process is not only important to intervene simultaneously on other cd segments causing complications, but also to provide the ibd mdt team with a full evaluation of the extent and severity of cd in that particular patient, in order to guide the tailored postoperative maintenance treatment. a standardised approach to intraoperative evaluation of extent and location of cd is desirable, based on reliable and reproducible techniques, minimising the risk of surgical recurrence, optimising the decision making on maintenance treatment and follow-up, protecting patients from unnecessary extended small bowel resections and risk of short bowel syndrome. the study objectives are to evaluate the feasibility of using intraoperative uss in patients with cd of the small bowel, and to describe the steps of the procedure. to assess safety of the intraoperative uss procedure during surgery. to evaluate the feasibility of study delivery, i.e. recruitment of study participants and retention at follow-up visits. to record surgical and patient outcomes up to 6 weeks to evaluate the direct and indirect costs of a standardised intraoperative uss protocol.

Eligibility criteria:
inclusion criteria: 1. aged 18 years or over 2. american society of anaesthesiologists (asa) grade i, ii or iii 3. undergoing elective surgery to remove part of the terminal ileum which is affected by cd. 4. . indication for surgery agreed at ibd mdt meeting 5. able to give written informed consent exclusion criteria: 1. undergoing emergency surgery 2. previous abdominal surgery for cd 3. pregnant
efficacy of cryotherapy combined with intralesional tuberculin ppd versus intralesional tuberculin ppd in treatment of multiple common warts

Conditions: Common Wart

Summary: the investigate the efficacy and safety of combined 'cryo-immuno-therapy' versus intralesional tuberculin purified protein derivative (ppd) antigen immunotherapy alone for multiple common warts

common warts are benign skin lesions caused by the human papillomavirus (hpv). the dorsal surface of the hands and fingers are the main predilection sites. cryotherapy is frequently used to eradicate common warts via necrotic destruction of hpv-infected keratinocytes or by inducing of an effective cell-mediated immune response. however, the cure rates of cryotherapy are only around (44-47%) . intralesional antigen immunotherapy represents a promising therapeutic approach for the treatment of different types of warts, particularly if multiple and/or recalcitrant. the investigate the efficacy and safety of combined 'cryo-immuno-therapy' versus intralesional tuberculin purified protein n immunotherapy alone for multiple common warts. although intralesional immunotherapy - compared to conventional therapeutic methods - has been generally along with better outcome, lower incidence of side effects and less recurrence, it is not still approved as a standard method of treatment in patients with wart , because the majority of available studies are open-labeled and randomized, placebo-controlled trials are very scarce. the immune system plays an important role in the spontaneous resolution of warts. the immune mechanisms against hpv include the development of cell-mediated immune response with activation of t helper1 (th1) lymphocytes resulting in long-term immunity . stimulation of the immune system would clear warts in other locations, eliminating the need for the local treatment for each individual wart . multiple studies support the use of intralesional ppd injection as an effective and valuable treatment option due to its systemic effect, especially for patients with multiple warts, with the benefit of clearance of both treated and distant warts.

Eligibility criteria:
inclusion criteria: 1. a dults older than 18 years 2. multiple (\>3 warts) common warts . 3. not currently using other treatments for a wart . 4. not had relapsed at least once after treatment with any of the tissue-destructive modalities. 5. positive tuberculin skin test. exclusion criteria: * acute febrile illness, history of asthma, allergic skin disorders.-1 2- pregnancy or lactation. 3- cold-induced diseases. 4- immunosuppression.

Keywords: wart intralesional tuberculin ppd
atorvastatin in the recipient's kidney graft from a living donor

Conditions: Renal Insufficiency

Summary: renal insufficiency is a priority disease in the health system, which may require renal replacement therapy based on kidney transplantation, which is considered as therapy of choice. during the procedure of kidney transplantation, the body is subjected to ischemia-reperfusion damage that generates late complications related to graft function. recently the anti-inflammatory and immunomodulatory effects of statins have been emphasized, which could be beneficial in kidney transplantation.

objective: evaluate the effect of atorvastatin on il2, il6, tnfalpha and hla levels in the recipient's kidney graft from a living donor. material and methods: controlled, double-blind trial with 12 months follow-up. composed of 48 patients, randomized manner, realized at the transplant department of western medical center, mexican institute of social security. universe was patients accepted as kidney donors and their recipients. patients included as donors were randomized into two groups (study or control) the intervention was implemented 4 weeks before kidney transplant. during surgical procedure, a biopsy from the recipient's kidney graft was obtained to measure il-2, il-6 tnfalpha and hla by immunohistochemistry, 3 and 12 months after surgery. recipients kidney function, surgical complications and kidney graft survival were registered. during surgical procedure, 3 and 12 months of following, biopsies were obtain to performed histopathological analysis based on banff classification of renal allograft rejection grades. the statistical analysis was performed according to the nature of variables, for continuous data using measures of central tendency and dispersion and for the qualitative data with frequencies and percentages. inferential analysis with student's t-test, and/or mann-whitney's u test; chi-square distribution, and/or fisher's exact test respectively.

Eligibility criteria:
donors inclusion criteria: * accepted as kidney donor * voluntary participation * informed consent accepted * 85% fulfillment of atorvastatin treatment * entitlement to the mexican institute of social security donors exclusion criteria: * hypersensibility to atorvastatin * smoking recipients inclusion criteria: * accepted as kidney recipient * entitlement to the mexican institute of social security recipients exclusion criteria: * patients who dropped out from study or withdrew the informed consent * insufficient kidney biopsy

Keywords: kidney transplantation atorvastatin human leukocyte antigens interleukin
perioperative hypoxemia in pediatrics

Conditions: Hypoxemia

Summary: the primary aim was to develop and validation of perioperative hypoxemia using clinical big data and deep learning technique in pediatric patients


Eligibility criteria:
inclusion criteria: * pediatric patients undergoing general or spinal anesthesia and monitored anesthesia care exclusion criteria: * none
radiosurgical hypophysectomy for bone metasteses pain

Conditions: Bone Metastases

Summary: this research is being done to see if a delivery of a single high dose of radiation therapy to a small area of the pituitary gland and pituitary stalk in a highly precise manner may be helpful in reducing intractable pain from bone metastases.

although not currently standard of care, small series suggest both safety and efficacy of radiosurgical hypophysectomy in reducing cancer pain from bone metastases. in spite of the demonstrated feasibility in meeting normal tissue constraints and preliminary data suggestive of both safety and efficacy, radiosurgical hypophysectomy is rarely performed in clinical practice, and many radiation oncologists are not even aware of its potential to reduce intractable cancer pain. this is likely because, to date, well-designed prospective studies have not been performed to further explore both the safety and efficacy of the intervention. this single arm pilot study is designed to fill that void. if successful, the investigators plan to utilize the data to support the proposal of a larger scale follow-up clinical trial.

Eligibility criteria:
inclusion criteria: 1. cytologic proof of malignancy 2. radiographic evidence of bone metastases 3. intractable pain uncontrolled by opioids, medical management, injections/ablation or surgical intervention that would be difficult to address with conventional radiation therapy or other standard options and is limiting the patient's function and quality of life. intractable pain will be defined as a visual analogue score of at least 4. 4. definitive radiographic progression of osseous and/or visceral metastases on standard staging scans (ct, mri, bone scan, pet scan or any other standard of care imaging) performed within the last 3 months in spite of standard oncologic interventions and/or inability to tolerate standard oncologic interventions 5. life expectancy at least 4 weeks 6. age≥ 18 years 7. patients of childbearing potential (male or female) must practice adequate contraception due to possible harmful effects of radiation therapy on an unborn child 8. patient must have the ability to understand and the willingness to sign a written informed consent document 9. all patients must be informed of the investigational nature of this study and must be given written informed consent in accordance with institutional and federal guidelines exclusion criteria: 1. prior brain radiation 2. patients must not have a serious medical or psychiatric illness that would, in the opinion of the treating physician prevent informed consent or completion of protocol treatment 3. isolated localized pain amenable to focal radiation therapy, or pain well controlled by opioids, medical management, injections/ablation or surgical intervention 4. malignancies being managed with curative intent 5. life expectancy \<4 weeks 6. the tumor amenable to curative management
a comparison of kinesio® taping methods for subjects with patellar tendonitis

Conditions: Patellar Tendinitis

Summary: the purpose of this study is to explore the possible effects kinesio tape may have on proprioception in individuals with patellar tendonitis. a supportive knee application, a facilitative hip application, and a combination of the two will be applied and compared. within and between group comparisons will be drawn. participants will report for two research sessions with 24-36 hours between. prior to arrival, they will complete a digital victorian institute of sport assessment for patellar tendonitis (visa-p) and email it to the researcher. participants must score less than 80 (out of a possible 100) to be considered for this study. if the individual meets the inclusion criteria, he/she will be scheduled for the 1st session. upon arrival to the first session, informed consent will be obtained, the visa-p will be reviewed, and intance of patellar tendonitis will be confirmed through palpation. participants will then completed a tampa scale for kinesiophobia (tsk) to measure fear of movement and a visual analog scale (vas) to measure overall pain. height and weight measurments will be taken due to requirements of the biodex balance system (bbs), which will be used for balance measurements. participants will take two, twenty-second practice tests, one with eyes open and one with eyes closed, followed by two minutes rest. baseline testing will then be completed as follows: the participant will complete two tests with eyes open, and two tests with eyes closed on the injured leg, each with one minute rest between. the participant will then be taped with kinesio tape to either the hip, knee, or both the hip and knee according to the random group assignment. they will then rest for 15 minutes and complete a second round of balance testing with the same parameters as baseline testing. participants will be scheduled for a second day no less that 24 hours and no more than 36 hours for re-test purposes. on the second day of testing, participants will be given $10 for their participation on day 1. if they want to continue with testing procedures, they will participate in the same balance testing procedures as day 1. the integrety of the tape application will be confirmed, and second tsk and vas scale will be administered. a final round of balance testing will be completed, and the participant will receive an additional $10 if they choose to complete both days of testing. this research will allow us to compare results of the tsk, the vas and the bbs testing both within subject and between group.


Eligibility criteria:
inclusion criteria: * score of less than 80 on the victorian institute of sport assessment for patellar tendonitis (visa-p) * experienced patellar tendon pain for greater than 14 days * tender to palpation at the patellar tendon. exclusion criteria: * knee surgery in the last six months * acute injury to the knee * any pain in the ankles, hips or core that may compromise balance testing * any allergy to adhesive * malignancies * cellulitis * skin infection * diabetes * fragile skin
comparative effectiveness trial in the treatment of pediatric plaque morphea

Conditions: Scleroderma

Summary: this is a study designed to evaluate the comparative effectiveness of topical medications for the treatment of circumscribed morphea.

morphea, also known as localized scleroderma, is a rare autoimmune fibrosing disorder that affects children and adults. morphea causes significant morbidity through atrophy and fibrosis of the skin and underlying structures. treatment can halt the progression of disease but cannot reverse disease damage, leaving children with disfiguring scars and sometimes functional impairment. consequently, it is of extreme importance to intervene early in the disease course with effective therapies to limit morbidity. circumscribed morphea is the second most common subtype in children, comprising approximately 1/3 of pediatric morphea cases. it is a disfiguring disease that can cause pain and pruritus. there are no fda-approved treatments and no consensus exists on the ideal therapy for circumscribed morphea, either in adults or children. most physicians use topical medications for circumscribed morphea yet there is little evidence to support these therapies. topical immune modulators such as tacrolimus, imiquimod, and calcipotriene have been investigated in small studies, though these trials were limited by very small sample sizes of 9-19 patients and lack of a control in most. surveys have demonstrated that topical steroids are the most commonly prescribed medication, even though the only evidence to support their use comes from case reports. with insufficient evidence regarding topical therapies, providers have no guidance when making treatment decisions, practice patterns vary widely even amongst pediatric dermatologists, and children continue with preventable scars. the investigators specific aim is to identify effective topical therapy for circumscribed morphea. the investigators will utilize a comparative cohort study design to evaluate the comparative effectiveness of three topical medications: clobetasol ointment, calcipotriene ointment, and tacrolimus 0.1% ointment. the investigators will enroll subjects at chw and other institutions to achieve the study enrollment necessary to power this study.

Eligibility criteria:
inclusion criteria: * presence of at least 1 active lesion of morphea on the neck, trunk, or extremities with no prior treatment to that lesion for at least 4 weeks exclusion criteria: * children receiving phototherapy or systemic therapy for their morphea * children with linear or generalized morphea * lesions on the face * greater than 3% body surface area involvement * open or ulcerated skin within morphea lesions
reducing the harmful effects of cannabis use: finding the optimal cbd:thc ratio

Conditions: Cannabis Use

Summary: this study will recruit healthy volunteers who use cannabis infrequently. each participant will attend the laboratory on five occasions: an initial visit to check that they are safe to join the study and four days of testing. participants will be administered, in a randomized order, vaporized cannabis containing one of four different ratios of cbd:thc (0:1, 1:1, 2:1, 3:1). the cannabis administration will follow a standardised inhalation procedure using a medical-grade vaporizer device. participants will complete a series of tasks measuring cognition, psychosis, anxiety and other subjective experiences. the study will be carried out at the nihr-wellcome trust clinical research facility at king's college hospital.


Eligibility criteria:
inclusion criteria: * female and male volunteers aged 21-50 * have used cannabis at least once * willing to provide written informed consent * willing to provide blood samples * fluent english speaker exclusion criteria: * past or present major mental illness * past or present major physical illness * past or present substance use disorder * past or present use of anti-psychotic or anti-depressant medications * first degree relative with psychotic disorder * currently taking psychotropic medication * positive urine drug screen at screening or experimental visits * use of alcohol 24h prior to experimental visit or tobacco on the day of experiment * pregnancy (current or planned) or lactation in women * significant abnormality detected during physical examination at screening visit * cannabis use (defined as days in which cannabis is used recreationally) more than once per week on average over the last 12 months * any past use of synthetic cannabinoids * score of 5 and above on the fagerstrom nicotine dependence questionnaire * bmi classified as obese or underweight * taken part in any drug study within the last 30 days or taking part in another study over the course of the trial * known drug sensitivity/allergy towards cannabis or lorazepam
68-ga psma 11 pet/mri and 68-ga rm2 pet/mri for evaluation of prostate cancer response to hifu therapy

Conditions: Prostate Cancer

Summary: this study is being conducted to determine whether the combination of imaging agents 68-ga rm2 and 68-ga pmsa11 is better at assessing response to high intensity focused ultrasound (hifu) or high dose rate (hdr) local therapy than standard imaging or biopsy in patients with known prostate cancer.

primary objective: to determine feasibility of 68ga-psma-11 pet/mri and 68ga-rm2 pet/mri for evaluation of hifu or hdr local therapy in patients with known prostate cancer.

Eligibility criteria:
inclusion criteria: * known prostate cancer * planned hifu or hdr local therapy * able to provide written consent * karnofsky performance status of 50 (or eastern cooperative oncology group (ecog) /world health organization (who) equivalent) exclusion criteria: * patients not capable of getting pet study due to weight, claustrophobia, or inability to lay still for the duration of the exam * metallic implants (contraindicated for mri)

Keywords: prostate cancer
clinical study on disposable sterile urinary catheter

Conditions: Urinary Catheters; Urinary Tract Infection

Summary: this study is a multicenter, randomized controlled study, with the urinary tract infection rate at the time of catheter insertion for 1 week as the primary end point. by comparing the clinical safety and effectiveness of two kinds of urethral catheters, to evaluate the clinical application effect of one kind of urethral catheters.


Eligibility criteria:
inclusion criteria: * 18-80 year old patients; * retained catheter ≥ 7 days; * patients who were conscious and had good communication skills and volunteered to participate in the study. exclusion criteria: * pregnant and lactating female patients; * diabetes patients; * patients allergic to sulfadiazine, silica gel and stainless steel; * urethral malformation, acute urethral injury, prostate disease, intermittent catheterization, suprapubic cystostomy and other patients who are not suitable for catheterization; * patients who have used urinary catheters for a long time or had catheters retained within one week; * patients who are participating in other clinical trials that interfere with this trial.